The contribution of emotional characteristics to breast cancer screening among women from six ethnic groups

Background. This study was designed to determine which of several emotional propensities were associated with the frequency of mammograms and clinical breast exams among six groups of minority women. Three emotion-related variables that have been identified in the previous literature as influencing screening were examined: Repression, cancer worry, and embarrassment. However, these variables have never been examined within the same study, nor where relevant background variables are controlled. Methods. 1364 African American, US-born white, English-speaking Carribean, Haitian, Dominican, and Eastern European women were recruited via stratified-cluster sampling. Participants provided demographics and measures of beliefs and knowledge. Results. As expected, self-regulation and cancer worry were both positively associated with mammogram and clinical breast exam frequency, while embarrassment regarding having a mammogram was negatively associated with screening. These results held even after controlling for demographic variables and the presence or absence of physician recommendation. Screening rates for African American women equaled or exceeded the rates for European Americans. Other minority subpopulations had even lower screening rates, including women from the English-speaking Caribbean and Haitians. Conclusions. Results are discussed in terms of their implications for screening intervention, models of health behavior, and the need for more precise operationalizations of ethnicity in screening research.